Chou H-C, Lin S-W, Chen W-W, Ke W-M, Chao P-H, Hsiao F-Y
Taiwan Drug Relief Foundation, Taipei, Taiwan.
Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan.
Int J Tuberc Lung Dis. 2014 Oct;18(10):1245-51. doi: 10.5588/ijtld.14.0155.
To investigate adherence to liver function monitoring as recommended in Taiwan's tuberculosis (TB) diagnosis and treatment guidelines for newly diagnosed TB patients.
Retrospective cohort study of the National Health Insurance Research Database (NHIRD), Taiwan, 2000-2011.
From the NHIRD, we identified 11 397 newly diagnosed TB patients who initiated anti-tuberculosis treatment between 2000 and 2011 and categorised these into three groups: completely, partially and non-adherent. Logistic regression was used to explore potential factors associated with the adherence rate.
The completely adherent rate increased from 0.5% in 2000 to 9.2% in 2011, while the non-adherent rate decreased from 17.5% to 1.2%. Compared to the non-adherent group, patients with a history of liver disease (OR 4.36, 95%CI 1.92-9.87) and viral hepatitis (OR 9.39, 95%CI 1.47-60.19), as well as patients whose prescribing physicians were specialists in chest (OR 4.59, 95%CI 1.91-11.05), TB (OR 2.55, 95%CI 1.01-6.40) and infectious diseases (OR 3.93, 95%CI 1.08-14.31), had higher odds of being completely adherent to the guidelines.
Our findings could serve as an important reference for developing effective strategies to improve adherence to guidelines and prevent patients from developing anti-tuberculosis drug-associated hepatotoxicity.
